Are Photos by Aid Workers an Invasion of Privacy in Haiti?

Earthquake survivors in a tent hospital in Haiti. Photo by Michelle May

I recently spent a week in Port au Prince, Haiti, helping in a tent hospital set up at the airport.

When I arrived back in San Francisco, I wrote about my experience in Haiti on my blog and posted pictures I had taken. I also posted photos on my Facebook profile, including images of smiling children who had just been operated on, long lines of patients, and even some “fun” photos, such as a few of me letting off some steam with a brigade of Portuguese firefighters at their camp (see photo at left).

Is it more invasive just because some of us don't have a press pass?"

Now, a rumor is circulating among volunteers that we should remove any photos of our time at the hospital from Facebook and other websites, unless we had received permission to take photographs.

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On one hand, it seems like a reasonable request. Some of the photographs posted by volunteers seem invasive: There are photos of an anonymous leg being cut into, an un-named mother giving birth, people who are clearly sedated, and bleary-eyed volunteers drinking beer at the UN café. They have attracted attention and criticism at the hospital, and among some of our Facebook friends.

One friend of mine, who put a strange mix of suffering, surgeries, and drunken party photos on Facebook, posted a rant defending her right to post whatever she wanted. Her logic: If CNN can film a woman giving birth, then why is it wrong for her to do the same? She pointed out she is saving lives, and had the cojones to drop everything to help in Haiti in the first place, unlike her critics back home.

This ethical debate is inspired by the ability of anyone to easily create and distribute media such as photos, videos or blog posts. Professional media have long been training their cameras and mikes on the victims of natural disasters, but now anyone can do it, too. Is it more invasive just because some of us don’t have a press pass?

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Glimpsing Freedom — And TV Cameras

Recently, a man who was rescued after being trapped for 27 days glimpsed the sky and the CNN cameras at almost the same moment. This isn’t surprising. At one point, when I was in Haiti, I was counseling a traumatized mute boy at the hospital when all of a sudden he and I we were swarmed by a U.S. news network camera crew. Their lenses were inches from the boy’s face as a doctor I had not met before talked about the boy’s needs and his “thousand-yard stare.” I remember thinking, “What this boy needs is for you to get the camera out of his face.”

Later, a reality show doctor showed up and demanded that doctors operate on an 87 year-old woman with a broken pelvis that the TV doctor had “rescued” from her home. A real doctor accused the TV doctor of exploiting a disaster for her own interests.

Perhaps this is why blogs, Facebook posts, and tweets from citizens can sometimes do a better job of putting a human face on the suffering in Haiti, and bring it home to people who may not otherwise pay attention. We’ve become desensitized to the way traditional media portray events like the recent one in Haiti; it’s possible that the authenticity contained in the accounts of non-journalists on the ground have a greater impact on folks back in the States.

Like most of those who have responded so generously to the crisis in Haiti, even the grandstanders probably had good intentions. But they can get in the way of those working to help the victims, and they can make it appear as if all of us on the ground are being insensitive, heedless of privacy, and are pumped up by our own do-goodedness.

Not surprisingly, the day after the reality TV doctor made her dramatic visit, strict media guidelines were put in place at the camp. Reporters needed to be vetted, sign in, and wear “authorized” media badges.

To Remove or Not?

So will I take all my Facebook photos down? Well, they have always only been accessible to my friends — but I did remove a few photos and stories from my blog. I will not, however, take down all my stories and photos. Even though I am returning to the hospital and don’t want to jeopardize my chances to do so, I feel certain that nothing I’ve posted is an invasion of someone’s privacy.

Then again, maybe I am simply desensitized and part of the system myself.

Haiti Return Trip

UPDATE (3/8/10): The above post was written after my first trip to Haiti, and since then I returned for another stint helping at the hospital. When I returned, relief workers weren’t allowed to board the plane in Miami until after we signed a declaration regarding photography: We would only take photos with permission, none of them would show someone suffering and only if they were for academic and medical purposes. This February visit was far more formal than my first visit to the tent hospital in January just weeks earlier.

I refrained from taking photos during my first day back at the tent hospital, which was not an easy task as I am someone who loves photography. Interestingly enough, I observed volunteers shooting pix, mainly on their iPhones. Later that night, a doctor showed me a photo of a patient’s foot — a case of Elephantitis — a condition that causes enlargement of certain extremities.

“This is the stuff you only see in textbooks,” the doc commented, making it clearly a legitimate educational photo. He went on to show me more photos, until he landed on one of a woman covered in surgical scrubs holding the hand of a patient in the ICU: “This one’s my favorite.” He did not realize that was me, under the surgical scrubs. Now the shoe was on the other foot, but in this case of course I did not mind. It showed me in my best condition — not sedated or suffering. I think some of us forgot that while showing us at our best we may be showing others at their most low points.

As the week went on I began taking photos — always with permission, and usually only patients who were on the upswing, with the exception of a patient who was on the brink of death who I worked very closely with. It was not for academic or medical reasons. I simply wanted to remember his kind face and his angelic eyes. The few days before that I had posted his story, using a fake name “Jean,” on my Facebook page. I was encouraged that his story moved poeple and that friends wanted to send money down to help him. Jean was happy to have his photo taken to remember our time together; he had a grace about him that I am sure I would not have in such a state.

Little did he know I was setting up a fund for him and his family. Even though Jean never said it, he was suffering. He was shot in the spine and was newly quadrapelegic. He was fighting infection and we had nearly lost him earlier that day. He and his family survived the quake, although their home did not. They felt lucky, but then an attempted carjacking left him paraliyzed.

Once back in San Francisco I spoke to one of my friends who had influence in the tent hospital. I made a general statement that there were “too many rules now.” She asked me to be specific. I was talking about photography. She had a strong retort letting me know that she did not aprove of the photos I posted on Facebook. She told me all the very obvious privacy rights of patients. If it was not me who had done it, I would be lecturing just the same. But when you are there, and it gets so personal, we tend to bend the rules, making exceptions for ourselves that we would not make for others.

After my piece published on MediaShift, a nurse I worked with wrote to me, wondering out loud if the photos she had posted on Facebook were inappropriate. I thought that they were. She went on to rationalize that she felt it was okay to be sure that the world knows what is happening there. Is it really neccesary for me to see how bloody bed sores can be on someone’s naked bottom, or actual blood dripping out of a just-amputated limb?

As someone thoughtfully commented on this site, it boils down to our own personal moral compasses. I would never think it’s okay to post such things, but for some reason this woman thinks that by us seeing blood coming out of a patient it will keep Haiti in the news and keep money coming in. Maybe she’s right and I just need to watch more of the Surgery Channel to get used to such images? Or maybe, like me, she became personally involved with these patients and wanted to tell their stories back home?

Michelle May is a San Francisco-based relief worker, traveler and school psychologist. Follow her travels on her blog.

One important question is whether or not a difference exists between for-profit and not-for-profit ventures. If Michelle May were offered money for her photos to be used by a media company, would that change the privacy concerns? What if she requested a donation to Haiti instead of her being paid?

I wanted to take a moment, before addressing the topic, to thank you for taking a time to take an honest look at a difficult situation.

To the topic:

As an American citizen, I have come to see that our public has this “need to know” type of mentality. We (as a group) tend to think that our question of “Why” should always be answered an with as much detail as humanly possible.

Which is why your topic is so difficult to address. On the one hand, without knowing what the people of Haiti as dealing with, we tend to forget that there is a problem. On the other hand, some people clearly that the need for information and use it to exploit people, which I believe is wrong.

You noted how a colleague used CNN reporting to defend their pictures, but can the news be viewed as a credible source of the “morality” of this type of situation, when they (news companies like CNN) are standing outside of a pre-school (clearly violating little children) in order to get information about Tiger Woods (not that I like or know the man – but stalking his kid is wrong). Or reporters are approaching children following things like school shooting, for ratings. To me, a person who wants to know and who cares, this is a moral violation maybe not a legal one, but a moral one indeed.

I viewed some of the pictures from Haiti. All of which ripped my heart out, and all I could think about was, how do you keep some of those pictures as a representation of a nation in chaos that needs our assistance, without promoting the others that clearly don’t realize (and maybe some of them do) that there are some images that cannot be captured?

Censorship is tricky, but mostly because it is one persons value system that can make a picture good or bad. What I think may need to happen is for photographers to ask themselves, “How would I feel if I was on the other end of the lens? Would I want this lasting image of me, in this state, to be the image people see when they think of me or my country/” Now some people would say, “Yes” in defense, but I say that if they can feel that way, then they need to swop out the word me for the word mother, father, sister – whatever it takes to get them to be honest.

I wish I could give you a direct answer, but I am very glad you posed the question.

I am also glad you had the opportunity to go to Haiti and be of assistance. Blessing to you.

I found this issue particularly interesting and important given the press the social networks received in the days immediately following the earthquakes. Twitter and Facebook updates were some of the best ways to see how the country was reacting. And now…totally different reception.

Thank you for the thoughtful comments everyone. As you point out, the line between telling Haiti’s the story & exploiting the story often was blurred- still is. I think some had good intentions- pushing the limits of what is acceptable because they thought it would keeps Haiti’s cause front and center in the public’s mind, and then lead to donations. In many ways that worked. Although i did not sense any media fatigue at the hospital (except some staff were annoyed with TV crews physically getting in the way of their work) once out on the streets, it was a different situation- though I never once felt threatened.

As far as getting paid for photos- I think there would be more tolerance if money was donated to directly assist Haiti rather than profiting individuals from relatively wealthy countries. Still, the majority of photos I have seen are freely circulating & are of adorable children-rather than bloody surgeries.

Thank you for your sensitivity & care for the people of Haiti & how they are portrayed in the media.

Thought provocing article, Michelle. I understand the need to respect privacy. However, I have greatly appreciated your pictures and have shared them with my husband and 8 year old stepson, and it gives us a much more personal look at the situation. My stepson is quite the little humanitarian and I think these personal photos are inspiring for not only him, but those he will affect by seeing the potential for the difference he can make someday.

I first posted photos of people in difficult circumstances in 1995 when I was working at demining in Laos, and then again in 1999-2001 when I was working in Indonesia. The Laotians were completely unlikely to see what I published. The Indonesians were very likely to see it. I quickly learned to post what people would be glad to see of themselves. On those occasions when I was wrong and they told me so and I took it down. If one thinks of what they post as being about friends who will see the material it isn’t too difficult to be sensitive.

I agree with Michelle May. A license or sanction does not make you a better reporter or finder of facts. passion and compassion make you a better person, reporter and give better credence to what to report and not to, as it enables people to do it in the name of reporting what is going on so the world can be educated, and not what is selling as sensationalized and / or televised by the media in the name of ratings.

First of all thank you for being there for these people. As to the subject, well as you state in your ground rules for a comment, Keep it civil! And after all isn’t journalism supposed to be about the truth? Not about what you want us to see or believe. Unlike most media outfits who put their own agenda before the truth of the matter.

This article is pertinent and is something that I believe should be addressed by all volunteer aid workers as part of the expected work ethic. IMO, photos of recognizable children and minors, especially in newsworthy situations that are likely seen by millions of people, should have permission by the children and their guardians to be published. This doesn’t mean that people can’t take pictures–what it means is they agree not to make them public if they don’t have the permission to do so. By doing so we are respecting the rights and dignity of those whose story we are telling.

This is an interesting balance, between your personal freedom and the right to privacy for the people, (some of which are children), in the photos. I think that we should each examine our own motives when we post content and if we are comfortable with it, then it is likely ok. However, when it comes to children, I do tend to err on the side of caution. I for instance do not even like posting photos of my friends’ children on facebook, without their permission. Keep up the good work and thanks for sharing your story.

I know someone from Chile living in Concepcion, I need to know if she is still alive, her name is Carolina Suazo, she used to play in internet in the web site names Buho21.com her nickname was Dulcita.

Michelle, my sincere thanks go to you and your friends that gave so freely of your time and talents to help those in need in anyway you could as they try to repair their lives from the devastation they have endured. Thank you all.

Thanks for posing the question on posting photos from these types of relief efforts. I am happy to follow the healthy, mature debate found on this blog.

IMO, I believe personal accounts to be more accurate than those smothered with network or celebrity agendas. I thank people for sharing their experiences to help offer a more honest window into the lives of persons in these situations. I agree that posting of kids should have the effort of securing approval from the child and /or guardian (if one can be found), but realize that may be difficult to do and still share the true perspective of the situation for others to learn and appreciate. Thank you again for giving of your talents and time Michelle.

I’m glad you posted this article. It is a difficult queston, but one that perhaps is easier to understand if you reverse your perspective. Think of yourself as one of the victims of the earthquake. You’re in complete chaos and have no control of your life. You’ve lost your network, family, friends, home, work, school, neighbors. You find yourself in a hospital/tent, being worked on by strangers who don’t know your culture, who don’t speak your language. Now they’re taking pictures of you in all your vulnerability. Later, someone shows you a picture or a video that has appeared on TV or in the news. You see your image. You feel violated.

Okay. Here are the usual rules: journalists can take pictures in “private” settings only when they receive permission from each and every person pictured. In “public,” say on the street, no such obligations exist, if the person has no expectation of privacy, because they are out and about on the street, in public, at a gathering, etc. But in a hospital, that is a private setting. Everyone has an expectation that a hospital, or with a doctor, your image, your body, your self, will be kept private.

Privacy. Respect. I would not want my picture taken during a traumatic event and then have that same photo passed around and shared among strangers of the world as entertainment masquerading as information.

Privacy. Respect. These are human beings and while aiding them is highly commendable, it does not give us the right to publicize their pain without first having given them the simple respect of asking for their permission. They are not children and having helped them does not put us in a ‘parental authority’ position over them. Our donations do not earn us that kind of power over other humans. I question the altruism of those who would argue that having helped or aided they have ‘paid their dues’ and therefore have the right to do as they please.

As for shooting and publishing photos of people under sedation without their knowledge or permission is just plain abuse. Does the fact these people are from a third world country make it OK? I know a lot of American’s would scream to high heaven if some third world denizen walked into an operating room, shot and then published photos of them while they were under sedation.

this is a really important article with excellent thought-provoking questions. i am partial to the sentiment of michelle may and disagree with the notion f sanctioning or license.

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